Endoscopic retrograde pancreatograms have been examined in patients presenting with cholestasis caused by either primary sclerosing cholangitis (13 subjects), or high cholangiocarcinomata (15 subjects), and in normal individuals (13 subjects). Pancreatograms were reported by two independent observers who had no knowledge of the diagnosis in any case and abnormalities were graded using a conventional scoring system. Pancreatograms were abnormal in 77% of cases of primary sclerosing cholangitis and in 60% of cholangiocarcinoma patients. These abnormalities usually consisted of side branch irregularities, although in five patients with primary sclerosing cholangitis and in two with cholangiocarcinoma, the main pancreatic duct was also markedly irregular.
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